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_ A�PLICA'TI`)N FOR ��n,,� �r��� everen <br />� l.,)NS1'itUCTION c°lif��_ = e <br />�vere�� PER;M�IT i�� <br />DF.P7. OF COMPdUtJITY DEVkLOPMFNT �FRVICES <br />CITY HALL 259-8745 <br />�VERETT, WA9B201 �COMBINATION ❑ 6UILDING L�hfECHANICAL ❑PLUMBING PIERMIT NO. <br />LCi 00. Uf SIGNf N <br />nfnit AUDHItiS <br />J <br />orv <br />TII' <br />-6 <br />GfNFPALCONT/tAC10N MAIIAUUN[SS ❑h LO' PIIOnL llC[NSEX <br />��+��,�v G��;ll. ,i�r�y�� ��t',c�� �'�1�.G zrg.yi9r �'E-,�c-�� <br />��TST1 n1AllAt)UHi55 CIIP K�S 1' 1'HQ�t tICINSEY <br />_fTh��n,al.L. �rs��N R;f« - Fl�wcr �� l.y �wwi� ��'aE� �"'o� -- yY�y <br />rwwuHe mNrenno¢ n�nn nooeFss arr z�r ri+�ne uu.�+se N <br />�G�Wr� ����� �%31 ,S�N��.c ��1�� �Sl -� yy z <br />cuss or woaK <br />�INEW ❑ADDITION ❑ALTERATION ❑NFPAIR ❑D[MOLITIO�N ❑FENCE ❑SIG� ❑GARAGE ❑6UILDING RELOCATION <br />VAWAiI NOfWORK <br />s , —�!'i�7f� � %�Z� Di�Q.fDO <br />DLSCRIfl[ \YOHK -- <br />1'NOPOSED U$E Of BUII�INf. <br />,f,�ylr �m. 17r�.�/r..c� <br />imni oescR r�io.v ov rxorrarr �siwwu utio.v ox nruai rouk coricsi <br />�orJ iv ���o�K,2Z�o� 7��7�sr� �ii✓ <br />F�v/ f,a T f`�7 <� JT ��" �tt�tii� <br />�-'Z" L'!— G4—'S <br />ion nooRess <br />/1 / a� �/ I T �T• Fi% f <br />PLUMBING <br />NO. TYPE OF FIXTURE FEE <br />BATHTUB <br />UVAiORYpYASH 11A: <br />SHOWER <br />KRCHEN SINK 8 DISP. <br />LAUNDRYT2AY <br />CLOTHfS\VASHER <br />WAiER HEAiER <br />DRINKING FOUNTAIN <br />FLOOR DRAIN <br />VACUUn BREAKEGS <br />ROOF DRAINS—RAINLI:ADEHS <br />$INK 6CRVICE—OAR, CTC 1 <br />SUB iOTAL <br />PFPMIT S <br />TOTAL FFF f G <br />SIDf. YARD SETBACK STREET SETOACK NfAR YARD SLil7�\CK <br />id v� � ��O <br />USE ZONE LOT,�NFA �{ GIr�P VAG\YT SIiP <br />3 30 �i�� — �,, � 5 �eN� <br />TVPE OF CONct ., ,� OCCUPApNCY GROUI' NO. Of DIVELLING Uti175 <br />� W"� �\ 3 � <br />SRE OF BLDG. NO. OF STONILS MA% OCC. I.OAU <br />1f t a r.s 1 <br />FlREZONE HASEMFNT 11tOH0�1�\11 flRf tiPNINKLIRS <br />fIEQUIRf.0 <br />3 ✓ .2 �,,5 , •:� <br />APPROVALS 11Y DAi[ <br />1. ENVIRONMENTAL CMKK LIST <br />2. �UILDING PUN$ <br />]. FIRE HYDRANT <br />i. FlRE PROTECTIUN SVSTEM <br />5. GRADINGIPXCAVAilOY R CIfANINGrC.NUI1111NG <br />4. DRAINAGC <br />7.ENVIRONAIF.NTALIMPACTSTATtMFNT <br />e. HFALTH �ISTRICT <br />APPLIGTION ACC. OY PUNS CHFCK[D B1' AI'PH FOK ISSUiWCt 111' <br />fV�w'I / <br />g.�.7q <br />I IiFRE13Y CERTIFY THAT I H�VE RFAD �ND EXAMINED THIS AP- <br />PLICA,TION AND KNOW THE S�ME TO UE TRUE AND CORRECT ALL <br />PROVISIONS OF LAWS nND ORDINANCES GOVERNING THIS TYPE <br />Of WOFtK WILL f3E COMPLIED WITH WHETHER SPECIFIED HERE�N <br />OR NOI�. THE GRANTING Of A PERMIT DOCS NOT PRESUMF TO <br />GIVE AUThIORITY TO VIOLATE OR CANCEL THE PROV!SIONS OF <br />ANV OTIiER STATE OR LOCAL LAW REGULATING CONSTRUCTION <br />Oh TH& PERFORMANCE OP CON TRUCTION. <br />$ICNqTURI� O� ACTOH Olt 7.ED AGENT DAT <br />X � , I�� j%� <br />MkCHAN�tAi <br />NO. TYPE OF EQUIPMENT <br />AIN �'ONU UNRS—H P FA <br />RFfFIGtHnTIONUNiTS—HP ln <br />❑OIL[RS—IIP fn <br />CnS � IRED A l U\ITS—TON.\'AGE EA <br />FORCC� AIH 51'STLN$—li T U. M <br />N'ALl HLnTtHS—f1.TU M <br />Utili H6\TIBS—Ii.T U. M <br />L\'APORATR'E CGOLENS <br />CIOIIIf 5 DRvf HS <br />vi �n.ono� rnn <br />/ wnr+ct �i000 <br />NIR HA\DLWG UNIT— C P.M. <br />5T0\'I. <br />/ MFiAL fB[PUCE S CIIIMNFl� <br />SUB TOTAL <br />PEPMIT <br />TOTAL FEE <br />PfAn CIItCR NUAtNFR <br />��y�� FFF <br />FffS <br />VAWATION <br />FEE <br />�f [q <br />CHECKPEE <br />NECEII'T NO. <br />L/� FEE � <br />iaunuitic 5 !!'Z ODp�� <br />PLUMIIING <br />MfCHANICAL <br />OIHfN <br />Pf NN TV 'JD.C. <br />SLC 307(a� <br />TOTAL <br />PERAIIT VAIIDATION <br />\VNI.N PROPIRIt' VnLIDATCD (IN THIi 51'ACI) TlII515 YOUN PERMIT <br />0 <br />/ <br />